Coexistence of Cervical Leiomyosarcoma and Gastric-Type Adenocarcinoma In Situ with Extensive Extension to the Endometrium and Fallopian Tube

Figure 4

Intraepithelial lesions. (a) H-E stain. Endocervical lesions. Neoplastic epithelium replaces normal epithelium on the cervical surface and glands. (b) Neoplastic epithelium with atypical epithelial and glandular cells with nuclear irregularity, variable sizes, mitosis, and apoptosis. Some glands have abundant pale eosinophilic cytoplasm, and partial glands have intestinal differentiation with goblet cells. AIS. (c) H-E stain. Endometrial lesions. Similar lesions in the endocervical mucosa. Cytological atypia was less than Figures 4(a) and 4(b); however they have mild nuclear atypia and pseudostratification. (d) H-E stain. The left tube mucosa is abnormal with mild nuclear pseudostratification, hyperchromasia, and enlargement, and tumor cells had mitosis. However, dysplasia was less than AIS. (e) H-E stain. Endometrium without lobular architecture and with the characteristic “pale pink” cytoplasm that was next to AIS. Simple gastric metaplasia (as indicated by arrow). (f) H-E stain. The endometrium showed lesions of stratified mucin-producing intraepithelial lesion (SMILE) focally. The stratified epithelium contains cells with mucin vacuoles in all cell layers. Nuclear atypia and hyperchromasia figures are present.

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